Negative Pressure Wound Therapy Assisted Closure: An Effective Mode of Management for Infected and Contaminated Wound With Non-Union Fracture Femur

Aims High-energy injuries can result in multiple complications, the most prevalent being infection. Vancomycin powder has been used with increasing frequency in orthopaedic trauma given its success in reducing infection following spine surgery. Additionally, large, traumatic injuries require wound coverage and management by dressings such as negative pressure wound therapy (NPWT). NPWT has been shown to decrease the ability of antibiotic cement beads to reduce infection, but its effect on antibiotic powder is not known. The goal of this study was to determine if NPWT reduces the efficacy of topically applied antibiotic powder. Methods Complex musculoskeletal wounds were created in goats and inoculated with a strain of Staphylococcus aureus modified to emit light. Six hours after contaminating the wounds, imaging, irrigation, and debridement and treatment application were performed. Animals received either vancomycin powder with a wound pouch dressing or vancomycin powder with NPWT. Results There were no differences in eradication of bacteria when vancomycin powder was used in combination with NPWT (4.5% of baseline) compared to vancomycin powder with a wound pouch dressing (1.7% of baseline) (p = 0.986), even though approximately 50% of the vancomycin was recovered in the NPWT exudate canister. Conclusion The antimicrobial efficacy of the vancomycin powder was not diminished by the application of NPWT. These topical and locally applied therapies are potentially effective tools that can provide quick, simple treatments to prevent infection while providing coverage. By reducing the occurrence of infection, the recovery is shortened, leading to an overall improvement in quality of life. Cite this article: Bone Joint Res 2021;10(2):149–155.

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Preoperative contaminated wound management using short-term negative pressure wound therapy with instillation

Journal of Wound Care ◽

10.12968/jowc.2021.30.12.994 ◽

2021 ◽

Vol 30 (12) ◽

pp. 994-1000

Author(s):

James Willmore ◽

Philip Wrotslavsky

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Treatment Plan ◽

White Blood Cells ◽

Case Series ◽

Wound Management ◽

Sodium Hypochlorite Solution ◽

Short Term ◽

Wound Therapy ◽

Contaminated Wound

Background: The short-term application of negative pressure wound therapy with instillation and dwell time (NPWTi-d) enables the delivery of topical wound solutions, the solubilisation of debris and cleansing of the wound bed. The application of NPWTi-d may support the transition of the wound to a more manageable state and minimises the use of more invasive techniques. Method: In this case series, we describe the process of applying NPWTi-d early as part of a contaminated wound treatment plan. Results: The case series included 15 patients in the preoperative setting. Wound types included surgical dehiscence, hard-to-heal wounds, heel pressure ulcers, diabetic foot ulcers, a cat bite and an amputation left open. Normal saline or a 0.125% sodium hypochlorite solution were instilled and allowed to dwell for five minutes, followed by 15 minutes of continuous negative pressure at –125mmHg. NPWTi-d was continued for 4–36 hours, or until the operating room became available. After NPWTi-d, we observed a decreased amount of devitalised tissue in the wound bed and reduced oedema and erythema in the periwound area. Patient white blood cells also significantly decreased in all cases after NPWTi-d (p<0.001). Conclusion: Short-term use of NPWTi-d may be a useful option for supporting the surgical treatment of contaminated lower extremity wounds.

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Negative Pressure Wound Therapy Tied to Complications

Internal Medicine News ◽

10.1016/s1097-8690(10)70078-0 ◽

2010 ◽

Vol 43 (2) ◽

pp. 6

Author(s):

ROBERT FINN

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Wound Therapy

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Prevention of poststernotomy wound infections in obese patients by negative pressure wound therapy

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0032-1332488 ◽

2013 ◽

Vol 61 (S 01) ◽

Author(s):

O Grauhan ◽

A Navasardyan ◽

M Hofmann ◽

P Müller ◽

J Stein ◽

...

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Obese Patients ◽

Wound Infections ◽

Wound Therapy

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Fragen zum Artikel: M. C. Nolff; A. Meyer-Lindenberg: „Vakuum – assistierte Wundbehandlung (Negative Pressure Wound Therapy, NPWT) in der Kleintiermedizin”

Tierärztliche Praxis Ausgabe K Kleintiere / Heimtiere ◽

10.1055/s-0037-1618341 ◽

2016 ◽

Vol 44 (01) ◽

pp. 38-38

Keyword(s):

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Wound Therapy

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Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽

10.33235/wcet.39.2.9-18 ◽

2019 ◽

Vol 39 (2) ◽

pp. 9-18

Author(s):

Wai Sze Ho ◽

Wai Kuen Lee ◽

Ka Kay Chan ◽

Choi Ching Fong

Keyword(s):

Wound Healing ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Assessment Tool ◽

Wound Care ◽

Wound Therapy ◽

Treatment Pathways ◽

Wound Assessment ◽

One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

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The effects and use of negative pressure wound therapy – a set of case reports

Perspectives in Surgery ◽

10.33699/pis.2020.99.4.183-188 ◽

2020 ◽

Vol 99 (4) ◽

pp. 183-188

Keyword(s):

Wound Healing ◽

High Risk ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Chronic Wounds ◽

Wide Spectrum ◽

Case Reports ◽

Modern Medicine ◽

Wound Therapy ◽

Basic Set

Modern medicine offers a wide spectrum of wound healing resources for acute or chronic wounds. Negative pressure wound therapy (NPWT) is a very effective method, allowing complicated defects and wounds to heal. The basic set is usually provided with various special accessories to facilitate the use and support safe application of NPWT to high-risk tissue. Selected case reports are presented herein to document the special use and combinations of materials in negative pressure wound therapy.

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